Marmara Üniversitesi Eğitim ve Araştırma Hastanesi

Objective: The coronavirus disease 2019 (COVID-19) mortality rate could be affected by such factors as blood cell counts, hematological markers, and comorbidities. This study investigated the relationships between these factors and mortality. Materials and Methods: This retrospective, cross-sectional, single-center study involved patients aged 18 and over, diagnosed with COVID-19, and admitted to a tertiary intensive care unit. Results: The patients’ median age was 70 (58-79) years, and more than half were men (n=238, 57.6%). Mortality occurred in the majority of cases (n=331, 80.2%), and the median length of stay in the intensive care unit was 17 (8-28) days. The majority of the patients had comorbidities (n=318, 77.6%). The median survival time was 18 [16.5–19.5] days, and the overall probability of survival for 28 days was 0.29 [0.25–0.34]. In the time-dependent Cox regression model, age over 70 (HR=1.87[1.45–2.42]; p

Background: This study aimed to evaluate maternal and perinatal outcomes in adolescent pregnan-cies. Materials and Methods: Adolescents aged 10 to 19 years and their newborns, who delivered at the Gynecology and Obstetrics Clinic of Mardin Education and Research Hospital between 2022 and 2024, were included in the study. Data were retrospectively analyzed from patient files and the hospital database. Outcomes were grouped as maternal and neonatal complications. Results: Neonatal and maternal complication rates were significantly higher in the adolescent group compared to the adult group. Adolescents experienced increased rates of anemia, eclampsia, and preeclampsia. Neonatal complications, including intrauterine growth restriction (IUGR) and tran-sient tachypnea of the newborn, were also more common in the adolescent group. The 1st and 5th minute Apgar scores of infants born to adolescents were significantly lower. Conclusions: This study confirms that adolescent pregnancies are associated with a higher risk of adverse maternal and neonatal outcomes. Anemia and hypertensive disorders are more commonly observed during pregnancy, especially in adolescents. Their newborns are more likely to have low Apgar scores, intrauterine growth restriction, and transient tachypnea of the newborn. These find-ings underscore the importance of prioritizing public health interventions aimed at reducing ado-lescent pregnancy rates and providing comprehensive support to young mothers and their infants.

Purpose: Linezolid (LZD) is an antibiotic which is effective against resistant gram-positive bacteria. The aim of this study was to investigate the characteristics and risk factors of linezolid-induced thrombocytopenia (LIT). Materials and Methods: This monocentric and retrospective study comprised 93 older patients treated with LZD for a minimum of seven days in a palliative care unit. Thrombocytopenia was defined as a decrease in platelet count below 150x103/mm3 or a ≥ 50% decrease. Complete blood count (CBC) and biochemical analyses were performed on the first, third, seventh, last day of treatment and after treatment. Results: The mean age of the patients was 73.7 years (±7.9 years). Thrombocytopenia was observed in 48 patients. The mean age, median duration of hospitalisation and LZD treatment were higher, and baseline serum albumin concentration and calcium level were lower in patients with LIT. In the groups aged ≥75 years, with albumin levels

The growing population of centenarians poses unique challenges to healthcare systems, particularly in orthopedic care, where age-related factors like increase susceptibility to fractures and complicate treatment. This study investigates epidemiological features, mortality risk factors and 1-, 6-, and 12-month mortality rates among centenarians (aged 100years and older) with orthopedic traumas, based on data collected from a tertiary trauma center. The hospital database searched from 2014 to 2023 revealed 23,458 trauma patients admitted to the emergency department of whom 116 were centenarians. 74 of them had bone fractures or dislocations that required treatment. Information of the patients were recorded from the patient's files, retrospectively. In this study, 82.4% of patients were female and the median age was 101 (100-108) years. Trauma ratio was found as 63.5% in the lower extremity and 36.5% in the upper extremity. Among the whole study group, 28.4% of the patients underwent surgery. The 1-month mortality rate was 16.2%, 6-month 28.4% and 1-year 41.9%. Males had a higher 6-month (p = 0.003) and 1-year mortality (p = 0.012) risks than females. Fracture localization and treatment preference were not associated with 6-month and 1-year mortalities. This study, which has the highest number of patients, explored factors affecting mortality in centenarians following orthopedic trauma showed, 1-month mortality rate was 16.2%, the 6-month mortality rate was 28.4% and the 1-year mortality rate was 41.9%, and revealed that fracture location did not influence 6-month or 1-year mortality. 3, case-control study. The online version contains supplementary material available at 10.1007/s43465-025-01429-y.

Purpose: Results regarding the clinical usefulness and predictive accuracy of inflammation-based parameters, including C-reactive protein (CRP), lactate dehydrogenase (LDH), and lactate in septic patients are conflicting. In our study, we aimed to evaluate the relationships of the combination of these inflammatory parameters with albumin, disease severity and prognosis. Materials and methods: 98 patients diagnosed with sepsis were categorised as survivors (n=68) and nonsurvivors (n=30) according to their intensive care unit (ICU) mortality. Prognostic factors were evaluated with the receiver operating characteristic curve and Cox proportional hazard regression model. Survival was analyzed with the Kaplan-Meier method. Results: Compared to survivors, nonsurvivors had increased CRP and lactate (13.5 vs 10.0, p=0.044; 2.2 vs 1.7, p=0.006, respectively), while LDH and albumin levels were not significantly different (246.0 vs 245.0, p=0.624; 2.9 vs 3.0, p=0.061, respectively). When combined factors were evaluated, CRP/albumin and lactate/albumin were significantly higher in nonsurvivors (4.9 vs 3.0, p=0.018; 0.8 vs 0.5, p=0.001, respectively), while LDH/albumin was similar in both groups (93.1 vs 78.9, p=0.148). Lactate/albumin had the highest AUC of 0.709 (p=0.001), while CRP had the lowest AUC of 0.628 (p=0.044). In a multivariate analysis of possible predictors of ICU mortality, only lactate could be an independent predictor of poor outcome (HR:1.998; p=0.020), while other variables were not independently associated. Conclusion: Increased CRP, lactate, CRP/albumin and lactate/albumin levels in septic patients were associated with poor outcomes. Lactate level was an independent predictor of mortality.

Increased salivation and contractions of the oropharyngeal muscles are frequently observed in Crisponi syndrome. This causes frequent recurrent lung infections. Anesthesia management can be challenging due to the frequent convulsions that occur during the intubation and extubation of the patient and subsequent cyanosis and hyperthermia attacks. Cold-induced sweating attacks may also occur due to the low operating room temperature. Hyperthermia attacks can lead to rhabdomyolysis and disseminated intravascular coagulation. Sudden deaths may occur in children with Crisponi syndrome. Hyperthermia, paroxysmal muscular contractions and trismus due to autonomic dysfunction are held responsible for sudden deaths.

Objective: To examine the effect of antenatal corticosteroid administration on umbilical artery (UA) Doppler measurements in pregnancies complicated with fetal growth restriction (FGR). Methods: This cross-sectional study was conducted with 149 pregnant women scheduled for antenatal corticosteroid therapy because of the possibility of preterm birth. UA Doppler measurements (PI, S/D ratio, RI) before antenatal corticosteroid administration and 24 and 48 hours after the last dose of corticosteroid administration were evaluated and compared with each other in pregnant groups complicated with FGR and uncomplicated with FGR. Results: No statistically significant change was observed in UA Doppler parameters 24 and 48 hours after antenatal corticosteroid treatment in each group with and without FGR. While there was no significant difference between the precorticosteroid UA Doppler parameters (PI, S/D ratio, RI) of the two groups with and without FGR, the values of these parameters 24 hours after the last dose of treatment were statistically higher in the group complicated with FGR than in the uncomplicated group. However, no statistical difference was observed in UA Doppler parameters between the two groups 48 hours after the last dose of treatment. Conclusion: Antenatal corticosteroid does not permanently affect UA Doppler parameters in the case of FGR. Close monitoring of the fetus for 72 hours after the first dose of antenatal corticosteroid may be helpful in pregnant women complicated by FGR.

Kafa tabanı önde nasion , arkada oksiputa kadar uzanan intrakraniyal ve ekstrakraniyal yapıları ayıran sınırdır. Kafa tabanı anatomik özelliklerine, patolojik lezyonlara ve onlara cerrahi yaklaşımlarına göre anterior, orta ve posterior olmak üzere 3 farklı bölgeye ayrılmaktadır. Kafa tabanı tümörleri en sık benign olmak üzere görülme sıklığı lokalizasyona göre değişmektedir. Ön kafa tabanında benign lezyonlar bunlar; menenjiyom, juvenil anjiofibrom, fibroosseöz lezyonlar daha sık iken malign lezyonlardan skuamöz hücreli karsinom (SCC) ve estezionöroblastom daha sık görülmektedir. Orta kafa tabanında benign lezyonlardan menenjiyom, hipofizadenomu, kordoma, kraniyofarenjiom, malign lezyonlardan nazofarenks kanseri, SCC sık görülmektedir. Arka kafa tabanında Glomus tümörleri, kordoma, schwannom ve otojenik SCC daha çok görülen tümörlerdir. Bu bölümde kafa tabanı anatomisinden, içinde barındırdığı önemli yapılardan, kafa tabanı tümörlerinden ve BOS fistülü tanı tedavisinden bahsedilecektir.

Hyaluronic acid (HA), known for diverse properties, was investigated for its potential in dental pulp therapy. This study investigated the potential of HA in dental pulp therapy by examining the physical properties and effects of zinc oxide eugenol (ZOE) pulpotomy materials containing varying HA concentrations on rat molar teeth. In vitro tests assessed compressive strength and hardness of ZOE materials blended with HA (0.5%, 1%, 3%) and HA gels (0.54%, 0.8%). 120 samples, encompassing the control group, underwent compressive strength testing, while 60 samples were designated for hardness assessment. In vivo experiments on rat molars studied histological effects of HA-containing ZOE on dental pulp over 1 week and 1 month. Gels with HA concentrations of 0.5%, 1%, and 0.54% were used in pulpotomy on 22 rats. Each rat underwent the procedure on four teeth, with one tooth serving as a control, totaling 88 teeth subjected to the intervention. In the analyses, SPSS 22.0 was used and the significance level was set at P = 0.05. Findings showed that HA at 0.5% maintained compressive strength, but higher concentrations decreased mechanical properties significantly (P = 0.001). Histological assessments indicated better outcomes with lower HA concentrations in terms of odontoblast layer continuity (P = 0.005 at 1 month) and pulp vitality (P = 0.001 at 1 week and P = 0.018 at 1 month). The study suggests HA holds promise for pulpotomy and regenerative endodontic treatments, but further research is needed to understand long-term clinical implications.

Günümüz dünyasında doğal afetlerin/salgınların artması, toplumun genel sağlık sisteminde de aksamalara neden olmaktadır. Bu bağlamda, teknolojik kapasitenin varlığı göz önünde bulundurulduğunda tele-tıp uygulamalarının dünya genelinde fayda sağladığı bilinmektedir. Temel pratiğe bakıldığında, tele-odyoloji ile odyolojik birçok değerlendirmenin ve programlamanın uzaktan yapılması mümkün kılınmaktadır. Ülkemizde ve dünyada bölgesel anlamda teknolojik kapasitenin geliştirilmesi ve testleri uygulayacak odyoloji profesyonellerinin sayısının artması, tele-odyolojinin gelişimine de katkıda bulunacaktır. Önümüzdeki yıllarda birçok alanda tele-sağlık hizmetlerinin artması ve Odyoloji alanında da bu yönde girişimlerin yapılması öngörülmektedir.